Severe Deep Bite + Impacted Canine Corrected Without Extractions

Class II malocclusion with severe impinging deep bite, skeletal deep bite facial pattern, hypodivergent, 6 mm overjet, proclined incisors, convex profile, crowding, and unerupted upper left canine.

Patient

Adolescent (12–17), male

Classification

Class II div 1

Active treatment

36 months

Published

September 13, 2026

Presentation

Chief complaint. "I want to to fix my overbite."

Diagnosis. Class II malocclusion with a severe 80–100% impinging skeletal deep bite, hypodivergent mandibular plane angle, 6 mm overjet, convex profile, proclined maxillary and mandibular incisors, mild maxillary crowding, and moderate mandibular crowding. Excessive overjet initially prevented anterior bite-turbo placement, and additional space was required for eruption of the permanent canines.

Measurements

Cephalometric values before and after treatment
Measure	Norm	Pre	Post
SNA	82	86	85
SNB	80	78	79
ANB	2	8	6
Wits	0	6	2
SN-MP	32	28	25
U1-SN	102	110	100
L1-MP	90	106	102
Overjet (mm)	2–3	6	2
Overbite (mm)	2–3	4	2

Treatment

Objectives. Correct the severe deep bite and Class II relationship, reduce overjet and incisor protrusion, create space for eruption of the permanent canines, resolve crowding, level and align both arches, and achieve a functional Class I occlusion.

Plan. Expand the maxilla to gain arch space, then place bite turbos on the lower second premolars to open the severe deep bite because the excessive overjet prevented anterior bite-turbo placement. Sequentially distalize the maxillary dentition to approximately a half-cusp Class II relationship, create space for the permanent canines to erupt, and use remaining growth with Class II elastics to complete the Class II correction. Level and align both arches and finish to a Class I occlusion.

Appliances and materials

Rapid Palatal Expander
Invisalign — Bite ramps bonded on the L5s to help extrude back teeth and unlock lower jaw
Class II elastics — 3/16 Heavy

Outcome

The upper left canine erupted successfully after adequate space was created. Mandibular growth helped complete the Class II correction, increased lower facial height, and brought the jaw forward to improve the profile. A Class I occlusion was achieved with improved vertical proportions and alignment. Treatment took longer than anticipated due to COVID-related interruptions.

Retention

Fixed U2-2 permanent retainer
Fixed U3-3 permanent retainer
Invisalign Vivera retainers to be worn at night